Prohibits downcoding in health insurance claims.
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Progress
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- Introduced
- Passed General Assembly
- Passed Senate
- To Governor
- Became Law
Overview
This bill prohibits health insurance companies and related organizations from using a practice called ‘downcoding’ in processing claims. Downcoding involves adjusting claims to a less complex or lower-cost service to reduce reimbursement to healthcare providers. The goal is to ensure providers receive full payment for the services they actually provide, protecting their revenue and aligning with existing fraud prevention laws.
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